CPotential Feedback Survey

Help us improve by answering a few questions about our services

Thank you for taking the time to complete our short feedback survey. As well as helping us improve our services, the information that you provide will help us secure funding so that we can continue to provide and develop our services.

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* 1. What CPotential services do you currently use, or have used in the past? Please select all that apply:

Conductive Education

Physiotherapy

CIMT

Occupational Therapy and Sensory Integration

Music Therapy

Independent Living

Mollii Suit

Online Services

None

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* 2. Do you currently attend sessions at CPotential?

Yes

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* 3. If you answered no, please could you let us know why you don't attend sessions at CPotential?

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* 4. What do you like most about the services you use at CPotential?

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* 5. Are there any ways that we could improve the services you use at CPotential?

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* 6. How do our services help your child? Please select all that apply:

Movement/motor skills

Sensory skills

Emotional skills

Self-help skills

Communication

Confidence

Independence

Social skills

Problem-solving skills

Other (please specify)

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* 7. How do you benefit from our services? Please select all that apply:

I feel more confident in my child’s abilities

I feel more comfortable in handling my child

I feel less anxious about my child’s wellbeing

I feel more motivated and enthusiastic

I have a better understanding of my child’s condition

I have a better knowledge of how to support my child’s development

I feel more relaxed about my child’s interaction with his/her peers/siblings

Other (please specify)

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* 8. What are the most important things to you when choosing a service? Please select all that apply:

Tailored specifically for your child’s needs

Clinically proven to benefit your child

Cost of services

Convenience of location

Friendly and approachable therapist/conductor

Enjoyable sessions

Welcoming premises and staff

Meeting other parents/carers

Other (please specify)

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* 9. Are there any barriers to accessing our services at CPotential?

Cost of sessions

Getting childcare

Getting to the centre

Making time for sessions around school/nursery

No barriers

Other (please specify)

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* 10. Have you accessed one of our bursary funded programmes? If yes, please let us know which programme you attended.

Yes

If yes, please let us know which programme

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* 11. If you answered yes to question 10, would you have been able to access our services without the bursary?

Yes

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* 12. We would really love your help to determine if there are other services or any complementary treatments that you think CPotential could investigate. Please provide details:

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* 13. How likely would you be to recommend our services?

Highly likely

Likely

Unlikely

Highly unlikely

Unsure

CPotential Feedback Survey

Help us improve by answering a few questions about our services

Question Title

* 1. What CPotential services do you currently use, or have used in the past? Please select all that apply:

Question Title

* 2. Do you currently attend sessions at CPotential?

Question Title

* 3. If you answered no, please could you let us know why you don't attend sessions at CPotential?

Question Title

* 4. What do you like most about the services you use at CPotential?

Question Title

* 5. Are there any ways that we could improve the services you use at CPotential?

Question Title

* 6. How do our services help your child? Please select all that apply:

Question Title

* 7. How do you benefit from our services? Please select all that apply:

Question Title

* 8. What are the most important things to you when choosing a service? Please select all that apply:

Question Title

* 9. Are there any barriers to accessing our services at CPotential?

Question Title

* 10. Have you accessed one of our bursary funded programmes? If yes, please let us know which programme you attended.

Question Title

* 11. If you answered yes to question 10, would you have been able to access our services without the bursary?

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* 12. We would really love your help to determine if there are other services or any complementary treatments that you think CPotential could investigate. Please provide details:

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* 13. How likely would you be to recommend our services?

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* 14. Please let us know if you have any other feedback comments: